双气囊小肠电子内镜检查相关并发症的临床分析

A clinical analysis about double balloon enteroscopy related complications

目的 评价双气囊小肠电子内镜（DBE）检查及内镜下治疗的安全性。方法 对2012年12月—2015年9月在武汉大学人民医院消化内科行DBE检查的208例患者临床资料进行回顾性分析,统计其相关并发症的发生情况,并分析其发生的原因。结果 208例患者中有10例进行了内镜下息肉切除治疗,其余198例单纯行DBE检查;208例患者中除3例因上进镜肠腔狭窄而终止检查外,其余病例均完成50%~100%的小肠检查,其中经口进镜25例,经肛门进镜8例,先后经口和经肛门进镜175例;术后高淀粉酶血症发生率35.10%（73/208）,急性胰腺炎发生率0.96%（2/208）,穿孔发生率0.96%（2/208）,麻醉相关并发症发生率0.48%（1/208）,出血发生率0.48%（1/208）,无死亡病例。其中1例出血发生在内镜下息肉切除治疗术后,73例高淀粉酶血症及2例急性胰腺炎患者均发生在经口进镜检查后。结论 高淀粉酶血症为DBE术后最常见的并发症,且基本都发生在经口进镜后,而急性胰腺炎、穿孔及出血等并发症发生率较低,DBE是一种安全、有效的检查及治疗方法 。

Objective To evaluate the security of the diagnostic and therapeutic double balloon enteroscopy （ DBE） . Methods The clinical data of 208 patients who underwent DBE from December 2012 to September 2015 in Renmin Hospital of Wuhan University were retrospectively analyzed.The occurrence of DBE related complications and its reasons were ana-lyzed.Results In 208 patients, 10 of them underwent polypectomies, the other 198 patients were performed diagnostic DBE. Approximately one half to all of the entire small intestine was observed by each approach in all cases except for 3 cases of se-vere intestinal stricture.25 of them were performed by oral and 8 by anal route, 175 patients were underwent both procedures. The rate of hyperamylasemia after DBE was 35.10%（73/208）, the acute pancreatitis was 0.96%（2/208）, the perforation was 0.96%（2/208）, the anesthesia related complications was 0.48%（1/208）, the hemorrhage was 0.48%（1/208） and the mortality is 0.In this study, one bleeding complication happened after ten polypectomies, and the 73 cases of patients with hyperamylasemia and the 2 cases of patients with acute pancreatitis were all after oral route.Conclusion Hyperamylasemia is one of the most common complication,approximately all of which happens after the oral processes.And the incidence of other complications such as acute pancreatitis, hemorrhage and perforation are lower.Comparatively, the hemorrhage happens after the therapeutic DBE more frequent then that of diagnostic DBE.After all, DBE is an effective and safe method for diagnosis and therapeutics of small bowel disease.